How to Become a Medical Assistant in 2026: Training to CCMA
The full route to working as a medical assistant, in order: program, NHA CCMA exam, state licence and renewal, with timings and what each step costs you.
- $45,690Median pay
- +13%Job growth
- About 1 year for a certificate or diploma; about 2 years for an associate degree (BLS)Training
- NHA CCMAExam
- $169Exam fee
Table of Contents
The route, start to finish
Becoming a medical assistant is a fixed sequence: an approved program, the NHA CCMA exam, then whatever your state requires on top. Here is every stop in order, with realistic timings.
- 1
Finish high school or a GED
PrerequisiteNHA requires a high school diploma or equivalent for full certification. Students still in high school can test for a Provisional Certification that converts after graduation.
- 2
Complete a medical assistant program
About 1-2 years (BLS)Enroll in a certificate, diploma or associate program at a community college, vocational or technical school. Expect clinical skills (vitals, injections, phlebotomy, EKG), front-office skills, and a supervised externship.
- 3
Apply and schedule the NHA CCMA exam
Create an NHA account and register ($169 individual list price), then test at your school, a PSI center, or by live remote proctoring.
- 4
Pass the exam
3-hour examAnswer 180 questions (150 scored) in 3 hours and reach a scaled score of 390 on the 200-500 scale. If you fail, you can retake after 30 days.
- 5
Meet any state requirement
Most states do not license medical assistants. Washington requires a state Medical Assistant credential; its Medical Assistant-Certified route accepts the NHA clinical medical assistant exam.
- 6
Start work as a medical assistant
Most medical assistants work in physician offices, hospitals and outpatient care centers. Many employers require or prefer certification and BLS (CPR) certification.
- 7
Renew every two years
Every 2 yearsComplete 10 NHA continuing education credits and pay the renewal fee ($195 every two years) to keep the CCMA active.
Step one: the right program
The program is the one step you cannot shortcut. The exam body checks where you trained before it lets you sit, so an unaccredited course can cost you the whole route.
Accreditation: NHA requires an accredited or state-recognized institution or provider, not a specific programmatic accreditor. Medical assisting programs are programmatically accredited by CAAHEP or ABHES, which matters for some state routes (for example Washington's accredited-program pathway) and for the AAMA CMA exam.
Typical length: About 1 year for a certificate or diploma; about 2 years for an associate degree (BLS)
Who is eligible to sit the exam
| Route | What you need |
|---|---|
| Training program | High school diploma or GED/equivalent, plus completion of a medical assistant training or education program within the last 5 years. The program can be offered by an accredited or state-recognized institution or provider, a registered apprenticeship, U.S. military medical training, or a verified employer-based program. Partner schools may let students test after coursework but before the externship; the externship must then be completed within 90 days (180 days for employer programs) or the score is voided. |
| Work experience | High school diploma or GED/equivalent, plus 1 year of supervised medical assisting work experience within the last 3 years or 2 years within the last 5 years. California residents using this route need at least 2 years as a medical assistant within the 5 years before the exam date. |
| Provisional (still in high school) | Students who meet the training requirement but have not yet finished high school or a GED may test and receive a Provisional Certification. It expires 12 months after the exam date, cannot be renewed, and must be converted to full certification after graduation. |
The exam itself
This is the checkpoint the whole route builds towards. The essentials:
Questions: 180 (150 scored)
Time: 180 minutes
Where you test: At your school/training institution, at a PSI testing center, or via live remote proctoring (LRP)
Passing standard: Scaled score method; scaled scores range from 200 to 500 and a scaled score of 390 or higher is required to pass (NHA Candidate Handbook, updated 06/01/2026)
Fee: $169
Eligibility in detail is in CCMA requirements, and how the score works in the CCMA passing score explained.
Licensure: what your state adds
Most states do not license medical assistants. They work under the supervision of a licensed provider, and each state's medical practice laws decide which tasks, such as injections, can be delegated to them. Washington requires a Department of Health credential; the Medical Assistant-Certified credential needs an approved training route plus a passing score on an approved national exam, and NHA's clinical medical assistant exam is on that list. California does not require certification to work as a medical assistant, but a medical assistant who trains other medical assistants must be certified by a certifying organization approved by the Medical Board of California, and NHA is not on the Board's current list of five approved organizations.
| State | What it requires |
|---|---|
| CA | Medical assistants are unlicensed and need no certification to work; they perform technical supportive services under a supervising provider who is on the premises, after training required by Title 16 CCR 1366. A 'qualified medical assistant' who trains others must be certified by a Board-approved organization (AAMA, AMCA, AMT, CCBMA, MMCI), hold a community college teaching credential, or teach at an accredited private postsecondary institution. NHA is not on the Board's approved list. Medical assistants may not be employed for inpatient care in a licensed general acute care hospital. |
| WA | Department of Health credentials: Medical Assistant-Certified, -Registered, -Phlebotomist, -Hemodialysis Technician and -EMT. MA-Certified requires an approved training route (CAAHEP/ABHES program, 720-hour program with 160-hour externship, or registered apprenticeship) plus a passing score on an approved national exam; the NHA clinical medical assistant exam is accepted. |
Pay and job outlook
The US Bureau of Labor Statistics files medical assistants under “Medical Assistants (SOC 31-9092)”. Median means half earn more and half less; pay moves a long way with state, setting and experience, so read this as a benchmark, not an offer.
Keeping the credential
Requirement: 10 continuing education credits per two-year cycle (2 hours of attendance = 1 CE credit). The same 10 credits apply to all NHA certifications you hold. NHA allows a one-month grace period. Reinstatement within 1 year of expiration requires 15 CE credits; after 1 year you must retake the exam. NHA's handbook adds that California CCMA holders who train other medical assistants must complete 60 CE hours every 5 years.
Fee: $195 every two years (NHA advertises it as about $8 per month). Reinstatement costs $391.50 total ($292.50 renewal + $99 reinstatement fee). Holding additional (stacked) NHA certifications carries a separate fee.
The exam is the step most people underprepare for
The CCMA app has 1,135 exam-style questions with explanations, organised by the same domains the exam uses. Work them by domain, find the weak area, and fix it before test day.
App StoreGoogle PlayFree CCMA practice testFAQ
How long does it take to become a medical assistant?
BLS says certificate and diploma programs usually take about a year, and associate degree programs about two years. After training you can sit the 3-hour NHA CCMA exam, and partner schools may let you test before your externship ends.
Do you need to be certified to work as a medical assistant?
In most states, no law requires it, but many employers require or prefer certification. Washington is an exception: it requires a state Medical Assistant credential, and its Medical Assistant-Certified route requires a passing score on an approved national exam such as NHA's.
How much do medical assistants make?
BLS reports a median annual wage of $45,690 for medical assistants in May 2025. Employment is projected to grow 13% from 2025 to 2035, with about 109,700 openings a year.
What is the difference between the CCMA and the CMA (AAMA)?
Both are national medical assistant certifications. The CMA from the American Association of Medical Assistants requires graduating from a CAAHEP- or ABHES-accredited program, while NHA's CCMA also accepts other accredited or state-recognized programs and a supervised work-experience route. Check which credentials your employer or state accepts.
Can I take the CCMA before I finish high school?
Yes, if you meet the training requirement. NHA issues a Provisional Certification that expires 12 months after the exam date and must be converted to full certification once you graduate. If it lapses, you retake the exam.
Sources
Figures on this page come from NHA and the other primary sources below:
- NHA CCMA Test Plan (based on 2022 job analysis)
- NHA - Medical Assistant (CCMA) certification page
- NHA - Now Available: CCMA 3.0 Certification Exam & Study Materials
- NHA Candidate Handbook (updated 06/01/2026)
- NHA Store - CCMA Exam Application ($169)
- NHA - Renew/Reinstate Certification
- NHA 2024 Pass Rates (revised 1/8/25)
- BLS Occupational Outlook Handbook - Medical Assistants
- Washington DOH - Medical Assistant credentialing requirements
- Medical Board of California - Medical Assistants
Checked October 3, 2026. Fees, outlines and eligibility rules change — confirm with NHA before you book.